Patient activation and health literacy in Dutch patients with multiple involved specialties

Abstract

Aim: To examine the association between having a higher number of involved specialties, patient activation (PA), and health literacy (HL) in patients visiting a general hospital. Subject and methods: Patients ≥ 18 years of age who had an appointment with the medical specialist or physician assistant were asked to participate in this study. Patients completed the Patient Activation Measure-13 (PAM) questionnaire and the European Health Literacy Survey Questionnaire (HLS-EU-Q). They were stratified into having < 3 or ≥ 3 involved medical specialties in the past 12 months. Two association models were built to examine the association. Results: This study included 200 patients with 52% males (n = 104), a median age of 65 years, and low levels of education (67%). Patients with ≥ 3 involved medical specialties (58%) had lower total PAM scores (p = 0.03) and had lower HLS-EU-Q index scores (p = 0.23). The multivariable regression analysis showed that having ≥ 3 involved medical specialties was not associated with low PAM scores (OR = 1.59, p = 0.13) when adjusted for low education, low HLS-EU-Q scores, and higher age (> 65 years). In addition, having ≥ 3 involved medical specialties was not associated with low HLS-EU-Q scores (OR = 1.10, p = 0.76) when adjusted for low PAM scores and low education. Conclusion: Patients with ≥ 3 involved medical specialties visiting the internal medicine department of a general (non-academic) hospital had variable levels of PA and HL. Moreover, having ≥ 3 involved medical specialties was not significantly associated with lower PA and HL. Importantly, the number of involved specialties may not be a proxy for recognizing low PA and HL. Organizations aiming to improve PA and HL could measure these constructs directly.